CT联合MRI在成人早期非创伤性股骨头坏死中的诊断价值

Effect of CT Combined with MRI in the Diagnosis of Early Adult Non Traumatic Necrosis of Femoral Head

目的探讨CT联合MRI诊断成人早期非创伤性股骨头坏死的价值。方法选取2020年1月至2021年1月医院收治的76例疑似成人早期非创伤性股骨头坏死患者为研究对象,所有患者均接受CT及MRI检查,以手术病理结果为金标准,分析CT联合MRI诊断成人早期非创伤性股骨头坏死的价值。结果手术病理结果显示,76例患者中,71例确诊为成人早期非创伤性股骨头坏死,占93.42%;其余5例均为髋关节滑膜炎,占6.58%;经Kappa一致性度量,CT诊断成人早期非创伤性股骨头坏死的结果与手术病理结果的一致性较差(Kappa=0.215,P<0.05);MRI诊断成人早期非创伤性股骨头坏死的结果与手术病理结果的一致性一般(Kappa=0.418,P<0.001);CT联合MRI诊断成人早期非创伤性股骨头坏死的结果与手术病理结果的一致性较好(Kappa=0.819,P<0.001);CT联合MRI诊断成人早期非创伤性股骨头坏死的准确度、灵敏度均高于CT、MRI单独检查,差异有统计学意义(P<0.05);CT联合MRI对Ⅰ期非创伤性股骨头坏死的检出率高于CT、MRI单独检查,MRI对Ⅰ期非创伤性股骨头坏死的检出率高于CT,差异有统计学意义(P<0.05)。结论MRI联合CT诊断成人早期非创伤性股骨头坏死具有较高的价值,可有效提高Ⅰ期股骨头坏死的检出率;且相较于CT、MRI单独检查,联合检查的准确度与灵敏度更高。

Objective The diagnostic value of computed tomography(CT)combined with magnetic resonance imaging(MRI)in early adult non traumatic necros is of femoral head was investigated.Methods 76 suspected early non traumatic femoral head necrosis patients admitted to the hospital from January 2020 to January 2021 were selected as the research subjects.All patients underwent CT and MRI examinations,and the value of CT combined with MRI in diagnosing early non traumatic femoral head necrosis in adults was analyzed based on surgical exploration results as the gold standard.Results The surgical results showed that 71 out of 76 patients were diagnosed with early non traumatic necrosis of the femoral head,accounting for 93.42%;The other 5 cases were all hip synovitis,accounting for 6.58%;According to Kappa consistency measurement,the consistency between CT diagnosis of early non traumatic femoral head necrosis and surgical results was poor(Kappa=0.215,P<0.05);The consistency between the results of MRI diagnosis of early non traumatic femoral head necrosis and surgical results is generally(Kappa=0.418,P<0.001);The results of CT combined with MRI in diagnosing early non traumatic femoral head necrosis are consistent with surgical results(Kappa=0.819,P<0.001);The accuracy and sensitivity of CT combined with MRI in diagnosing early non traumatic femoral head necrosis were higher than those of CT and MRI alone,with statistically significant differences(P<0.05);The detection rate of CT combined with MRI for stage I non traumatic femoral head necrosis was higher than that of CT and MRI alone.The detection rate of MRI for stage I non traumatic femoral head necrosis was higher than that of CT,and the difference was statistically significant(P<0.05).Conclusion MRI combined with CT has high application value in the diagnosis of early non traumatic femoral head necrosis in adults,which can effectively improve the detection rate of stage I femoral head necrosis;Compared to CT and MRI examination alone,the combined examination has higher accuracy and sensitivity.